Nucpaedia
Nucpaedia
Paediatrics · ⁹⁹ᵐTc-MDP · Advanced

A 2-year-old who will not bear weight

History

2-year-old boy with 3 days of refusing to bear weight on the left leg. No injury was witnessed. Temperature 37.8 °C, CRP 14 mg/L, white cell count normal. Radiographs of the left leg reported as normal; hip ultrasound shows no effusion. Request: bone scan — osteomyelitis?

Step 1 · Whole-body and knee images

The physes are intense and symmetrical. Just below the left proximal tibial physis there is a focal area of increased uptake in the metaphysis, while the physis itself looks normal. How do you describe the knee finding?